Presbyterian Products

Presbyterian is proud to offer a range of product choices. The wide variety of plans are designed to meet the very different needs of different Employer Groups and individuals. Choose among plans features such as lower premiums, varying copayment/co-insurance amounts, deductibles and options for seeking care outside the Presbyterian provider network. Whichever plan you choose, you can have the comfort in knowing you'll have access to the healthcare provider local consumers prefer above any other. And that's something to feel good about!

Presbyterian Employer Group Plans

Presbyterian's employer group plans include HMO, POS and PPO Plans for New Mexico businesses. Our HMO products include standard HMO copayment style plans; our Smart Care plan offers a combination of copayments and deductible/co-insurance; and our POS plans allow members the opportunity to access in and out-of-network providers. We also offer several different deductible and co-insurance level PPO plan choices.

ASO/Self-Funded

Self-funded is an arrangement whereby the employer assumes some or all of the risk in providing health benefits for the employees. In New Mexico, self-funding can save the employer 2-6% in premium taxes which do not apply in self-funded plans, potential freedom from costly state-mandated benefits and investment earnings which accrue typically tax free in the employer-established health trust.

For additional information on self-funded plans please contact the ASO team, or access Section II of Presbyterian's Field Underwriting Guidelines (.pdf).

Presbyterian State Coverage Insurance (SCI)
This plan offers affordable healthcare coverage to low-income working adults who meet the SCI eligibility criteria, either through their employer or as an individual.

Presbyterian Individual Plans

• PresMetro
  The new PresMetro plans offer an innovative new option for residents living in the four-county Albuquerque metro area (Bernalillo, Valencia, Sandoval, and Torrance, including Edgewood).  Benefit highlights include five annual calendar year deductibles and three pharmacy benefit options to choose from; unlimited Preventive Care covered at 100%; and up to a $100 unique reimbursement per family for services such as dental and vision care, disease management classes, alternative therapies and non-covered prescription drug costs.
• PresSolo
  PresSolo is our statewide individual plan that provides total wellness coverage for our members and their families.  Many of this plan's benefits are similiar to those listed for the PresMetro Plan above.
• Individual Care
  Our Individual Care PPO plans offer simple copayments for doctor visits, routine physicals, and prescription drugs. For more advanced medical needs, like hospital services or diagnostic tests, members first meet a deductible then pay 20% of the service when the care is provided by the Presbyterian network.
• Advantage Care
  The Advantage Care plans are qualified High Deductible Health Plans which can be used with a member-owned, portable Health Savings Account (HSA), a savings option that may provide you with tax advantages. For added convenience, Presbyterian has partnered with Wells Fargo to assist you in opening an HSA account. The Advantage Care plans provide two pharmacy benefit options:
  1. Prescription coverage built into the medical plan
  2. Plans without pharmacy benefits built-in

Presbyterian Senior Care: Our Medicare+Choice Option

Did you know Presbyterian Senior Care offers Multiple Employer Group Medicare+Choice plans?